In an op-ed for the National Review, psychiatrist Sally Satel writes, “No civilized or lawful purpose is served by executing the severely mentally ill.” Satel is a senior fellow at the American Enterprise Institute, and she highlights the deficits in the current legal system that permit capital sentences and executions for those suffering from severe mental illness. “The requirements to qualify for the insanity defense set the bar so high that few mentally ill defendants can meet it,” she writes. “There needs to be a middle ground for mentally ill defendants who do not meet the standards for the insanity defense but who, because their reasoning is too impaired, cannot be held fully responsible for their crime. They should face life imprisonment or, what would be more compassionate, confinement for life to a psychiatric facility, but not the death penalty.”

Satel cites the case of Andre Thomas, a Texas death-row prisoner who has long suffered from mental illness so acute that he repeatedly mutilated himself and is now blind. Although the U.S. Supreme Court has prohibited capital punishment for those with intellectual disability (Atkins v. Virginia, 2002) and exempted those “who fail to understand the reason for their imminent demise” (Panetti v. Quarterman, 2007), “no court has ever addressed a more fundamental matter: the eligibility of someone as mentally ill as Thomas, clearly psychotic at the time of the crime, to receive a death sentence in the first place,.”

Satel argues that “The same judicial sensibility can and should apply to severely mentally ill defendants,” and she urges state legislatures to adopt legislation such as that in Ohio that exempts those with severe mental illness from a death sentence. She also advocates for court action: “When an appropriate case comes before the Supreme Court, it should interpret the Eighth Amendment as barring execution of mentally ill individuals whose commitment of murder was the result of their deranged thinking. If this were already the law of the land — or of Texas — we would not be looking at the possibility that Andre Thomas might be executed.”


Sally Satel, The Flawed Case for Executing the Mentally Ill, National Review, March 122023